When Hurricane Katrina lashed out at residents of the Gulf Coast-hitting the most vulnerable people hardest-the nation was given a powerful reminder of what's at stake if the country's health care system remains inefficient and in crisis, said John Kerry, Massachusetts Senator and 2004 Democratic Presidential candidate, at the Opening Session of the American Public Health Association's (APHA) annual meeting in Philadelphia on December 11.
"A lot of people say that Katrina was a wake-up call, but it has opened people's eyes to something that they really should have seen a long time ago," said Kerry, "and if it's going to mean anything, it needs to challenge all of us to change the direction of our country, particularly to change the shocking state of health care in America."
Many children who fled the hurricane received their first vaccinations ever in shelters, he said. Adults in those same shelters received medical screenings for previously undiagnosed and untreated health problems. Now, as the Gulf Coast recovers from the hurricane, the real question is whether the health care system will remain indifferent to the needs of the vulnerable, he said.
Kerry has introduced legislation in the U.S. Senate called the "Kids First Act" in which the federal government would pay all Medicaid outreach and coverage costs for children under age 21 with incomes at or below poverty level, while states would pay their share of SCHIP or Medicaid coverage expansion costs for children at higher income levels. SCHIP refers to state health insurance plans for children.
The proposal has sparked debate, with critics charging that the legislation would create extra bureaucracy and expense. Kerry said the proposal would actually save states money.
Senator John Kerry
"The real test of Katrina, the real test of who we are as Americans is not whether you hear about this in speeches," said Kerry. "It's about whether or not we're going to actually summon the common sense of our country to do what is morally and practically correct-whether we are going to do something to reverse the injustice that left so many of our least fortunate waiting on those rooftops in New Orleans."
Kerry was interrupted several times by apparent protestors demanding troop withdrawal from Iraq. He set aside time at the end of his speech to address the war, saying that he made a difficult choice when he voted to transfer authority to the President to use force if necessary to remove Saddam Hussein from power. He said that the vote was based on a set of information that was not the same as what the administration had.
"I believe that we begin the process of withdrawal not as a matter of withdrawal, but as a matter of succeeding, and that any plan for success is based on a plan that includes the reduction of our presence, the redeployment of our persons, and what I have said again and again is-it is time for Iraqis to police their communities, go into their homes, search for people. It's time for Iraqis to stand up for Iraq, and it is time to begin to bring those troops home on an orderly basis as we establish those benchmarks of success," said Kerry.
Fighting for Public Health
APHA president Walter Tsou stressed in his address the importance of public health as a foundation for health care, a fact made more prevalent in a year of disasters that included a tsunami, an earthquake, hurricanes, and wars. Yet only one percent of health care dollars in the U.S. is spent on population-based health care. And more and more public health programs are seeing their funding reduced dramatically.
Tsou urged members to talk to their senators and representatives about the importance of public health, saying the field's future rests in the hands of its practitioners. He laid out the choices in a surging list that took the rollicking audience to its feet: whether or not to have workers knock on doors to help TB patients; whether or not to improve air quality to help people breathe more easily; whether or not to have universal health care in the U.S.; whether or not to make restaurants in Philadelphia-the meeting's host city-smoke-free; whether or not to support family planning; whether or not to eliminate health disparities and fight for social justice; whether or not to build a stronger public health infrastructure to make a better America.
"The truth is we often cut prevention as the first thing," said Tsou. "We are penny-wise and pound-foolish."
Plenary Session
APHA devoted the final segment of the Opening Session to a panel about Hurricanes Katrina and Rita. The speakers were: Kevin Stephens, director of the New Orleans Health Department; Jimmy Guidry, state health officer and medical director, Louisiana Department of Health and Hospitals; Mollyann Brodie, vice president and director, Kaiser Family Foundation; and Eduardo Sanchez, commissioner of health, Texas Department of Health. Maureen Lichtveld, chair of the Department of Environmental and Health Sciences at Tulane University, served as moderator.
The panelists addressed the difficulties in simply communicating with agencies and other groups during a disaster, the need for flexible policies on health care delivery and public health to accommodate ever-changing situations, and the importance of keeping public health responses at the forefront of emergency management.
Public Health Legislator Awards
Each year, APHA honors distinguished legislators for their work in public health. This year's awards were given to U.S. Sen. Jeff Bingaman, D-New Mex., Arkansas Gov. Mike Huckabee, U.S. Sen. Daniel K. Inouye, D-Hawaii, and Maryland State Rep. Shirley Nathan-Pulliam.
Bingaman was honored for his lead in Medicaid reform debates. Huckabee was noted for his insistence that all of Arkansas' tobacco settlement money go toward improving state residents' health and for his Healthy Arkansas initiative to encourage Arkansans to stop smoking, exercise more, and eat healthier. Inouye was recognized for his lifelong support of health, the environment, and Native American and Native Hawaiian issues. Nathan-Pulliam was honored for supporting legislation addressing health disparities and for bringing attention to health and minority issues in Maryland. For more information on these awards, visit http://www.apha.org/news/press/2005/outstandingLegislators.htm.
At the Opening Session, Linda Degutis, chair of the APHA's Executive Board, also recognized the association's convention-planning staff, who worked hard and quickly to relocate the meeting from New Orleans to Philadelphia after Hurricane Katrina hit the Gulf Coast.
Copyright, 2007, President and Fellows of Harvard College
